Mahjoub Heba, Konstantinou Eleni K, Mills Huan M, Laver Nora M V, Chang Jeffrey
Department of Ophthalmology, Tufts Medical Center, New England Eye Center, Boston, USA.
Department of Ophthalmology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.
J Med Case Rep. 2025 Mar 24;19(1):135. doi: 10.1186/s13256-025-05041-4.
Choroidal metastasis is the most common intraocular malignancy in adults, commonly presenting in later stages of the disease and associated with poor prognosis. This is the first case to describe choroidal involvement as the sole initial metastasis of the rare biphasic pulmonary tumor.
A 42-year-old white male patient presented to the emergency department with 3 weeks of progressive temporal visual field loss in the left eye (oculus sinister) with slight discomfort to palpation. At the emergency department, he underwent computed tomography and computed tomography angiography of the brain to rule out a central nervous system etiology of his vision loss. The imaging demonstrated lentiform dependent hyperdense material with layering hypodensity within the medial aspect of the left globe, consistent with choroidal detachment. His prior medical history was significant for biphasic pulmonary blastoma cT2N2M0 stage IIIA involving the right lung, with extension into the superior vena cava, diagnosed 3 years prior to the current presentation. He was treated with chemoradiation and excision with complete response to therapy.
As the survival rates for cancer patients are increasing owing to better quality and more available treatments, choroidal metastasis may become more common. Early diagnosis and effective treatment of these lesions is crucial for better patient outcomes.
脉络膜转移瘤是成人最常见的眼内恶性肿瘤，通常在疾病晚期出现，预后较差。这是首例将脉络膜受累描述为罕见的双相性肺肿瘤唯一初始转移部位的病例。
一名42岁白人男性患者因左眼（左眼）进行性颞侧视野缺损3周伴触诊轻度不适就诊于急诊科。在急诊科，他接受了脑部计算机断层扫描和计算机断层血管造影，以排除视力丧失的中枢神经系统病因。影像学检查显示左眼球内侧有扁豆状高密度物质，内部有分层低密度，符合脉络膜脱离。他既往有双相性肺母细胞瘤病史，cT2N2M0 IIIA期，累及右肺，延伸至上腔静脉，在本次就诊前3年确诊。他接受了放化疗和手术切除，治疗后完全缓解。
由于治疗质量提高和可及性增加，癌症患者的生存率正在上升，脉络膜转移可能会变得更加常见。早期诊断和有效治疗这些病变对于改善患者预后至关重要。
